Prophylactic cranial irradiation prevents early lung cancer metastases to the brain

Jun 3 2009

A national Radiation Therapy Oncology Group (RTOG) study led by a Medical College of Wisconsin Cancer Center physician at Froedtert Hospital in Milwaukee has found that a course of radiation therapy to the brain after treatment for locally advanced non-small cell lung cancer reduced the risk of metastases to the brain within the first year after treatment. The study was presented at the American Society of Clinical Oncology annual meeting in Orlando, June 1.

“With improved treatments for non-small cell lung cancer, patients are living longer and we are seeing more brain metastases,” says study author Elizabeth Gore, M.D. “This study compared the efficacy of prophylactic (preventive) cranial irradiation (PCI) vs. observation in these patients, and found that those not receiving cranial irradiation were two and one-half times more likely to develop brain metastasis than those who did.”

The study analyzed 356 patients. While the results did not show a statistically significant difference in survival between the two groups, it did show that PCI significantly decreased the incidence of brain metastases during the first year post-treatment. Dr. Gore anticipates that additional study of the impact of PCI --on neuro-psychological function and quality of life in these patients-- will help determine if use of PCI should become standard care.

Dr. Gore is associate professor of radiation oncology at the Medical College. Co investigators included K. Bae, of the Radiation Therapy Oncology Group, Philadelphia, PA; Stuart Wong, M.D. of the Medical College of Wisconsin; J. Bonner of the University of Alabama at Birmingham; A. Sun, of the Princess Margaret Hospital, University Health Network, University of Toronto; S. Schild of the Mayo Clinic Arizona in Scottsdale; L. E. Gaspar of the University of Colorado Cancer Center in Aurora; J. Bogart of SUNY Health Science Center at Syracuse, NY; M. Werner-Wasik of Thomas Jefferson University Hospital in Philadelphia, and H. Choy, University of Texas Southwestern Medical Center in Dallas.

RTOG, an NCI-funded national clinical trials group, is a clinical research component of the American College of Radiology (ACR). Through the NCI Clinical Trials Support Unit this study was open to members of the Eastern Cooperative Oncology Group the National Cancer Institute of Canada the North Central Cancer Treatment Group, the Southwest Oncology Group, and the Cancer & Leukemia Group B.

The research was funded by Grants from the National Cancer Institute.